583final Flashcards
The nurse is discussing the plan of care with the parents of a 3-year-old girl with an acute presentation of idiopathic thrombocytopenic purpura (ITP). The parents of the client demonstrate an understanding of the teaching by stating which of the following?
a. “Most children with ITP eventually require a bone marrow transplant.”
b. “ITP is usually caused by some kind of cancer.”
c. “ITP can be cured by steroids.”
d. “ITP is self-limiting in the majority
ANS: D
Which of the following would place an infant at increased risk factors developing anemia? SELECT ALL THE APPLY.
a. Experiencing a growth spurt.
b. Excessive milk ingestion.
c. Being born premature.
d. Introduction of semisolid foods into the diet at 4 months of age.
e. Exclusively breastfeeding
ANS: A, B, C
The nursing is caring for a child with suspected acute epiglottis. Before inspection of the throat, the nurse should confirm that equipment is available to proceed with _________.
ANS: intubation
Six-month-old child is admitted to the pediatric unit with a diagnosis of bronchitis. The doctor order to keep the child NPO because
a. Oral fluids increase mucus production.
b. Hydration is not a concern in bronchiolitis.
c. Hypoxemia decreases gastrointestinal motility.
d. Tachypnea causes child to aspirate.
ANS: D
The nurse is caring for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. The nurse should anticipate which of the following in the plan of care?
a. Apply heat to affected area.
b. Encourage regular exercise.
c. Oxygen therapy, even if the patient is not hypoxic.
d. Administration of meperidine for pain control.
ANS: A
Identify the nursing responsibilities associated with giving Albuterol (check all the apply).
a. Evaluate patient for signs of dyspnea (accessory muscle use).
b. Albuterol causes bradycardia. Your patient should have a cardiac monitor and automatic BP machine.
c. Check patient’s pulse oximeter O2 saturation and heart rate
d. Check breath sounds before and after treatments
ANS: A, C, D
A nurse is educating the parents of a school-aged child newly diagnose with hypothyroidism. Until the disease is under control, which instruction should be included in the education provided by the nurse?
a. Restrict the number of calories from carbohydrate foods.
b. Discontinue physical education classes at school.
c. Increase stimulation in the school environment.
d. Dress your child in cold weather clothing even in warm weather.
ANS: B, d/t risk of cardiac problems.
The nurse is reviewing a healthcare provider’s prescriptions for a child with severe hemophilia A. Which prescriptions documented in the child’s record should the nurse question? SELECT ALL THE APPLY.
a. If possible, change intramuscular medications to be given subcutaneously.
b. Give desmopressin.
c. Give factor VIII.
d. Administer aspirin for fever or pain.
e. Draw all blood samples by venipuncture.
ANS: B, D
A nurse is finishing up discharge instructions with parents of a 10-year-old who was seen in the pediatric clinic for LTB. The nurse knows that the teaching has been successful if the parent makes which of the following statements about the care of croup syndromes?
a. “I will expect her to require a full course of antibiotics.”
b. “If I hear an expiratory stridor the croup is coming back.”
c. “I need to make sure that she gets enough fluid intake to keep her well hydrated.”
d. “I know that the cough will be worse during the day.”
ANS: C
The nurse is caring for a child with panhypopituitarism. The nurse expects which of the following clinical manifestations. SELECT ALL THE APPLY.
a. Proportional weight and height
b. Hyperglycemia
c. Accelerated puberty
d. Polyuria
e. Short stature
ANS: A, D, E
A 3-year-old client is being treated for LTB. The nurse notices that the patient has stridor at rest and moderate retractions. The nurse anticipates which of the following in the plan of care? SELECT ALL THE APPLY.
a. Administer a corticosteroid.
b. Administer a nebulized epinephrine.
c. Reassurance to calm the patient.
d. Administer a bronchodilator.
e. Administer intravenous magnesium sulfate.
ANS: A, B, C
A nurse admits a newborn with a visible cleft lip lesion. Which step of the newborn’s assessment is now the MOST important?
a. Attempt oral feedings to assess suck/swallow reflexes.
b. Inspect the palate and gums.
c. Prepare the infant for surgery to close the defect.
d. Assist the mother with breast feeding.
ANS: B
The nurse must assess for cleft palate in addition to the cleft lip. Feeding should not be attempted until the assessment for cleft palate is completed. Surgery is not indicated until age 2-3 months.
A 16-month-old male infant is admitted for dehydration. The mother states that he has only had 3 wet diapers in the past 24 hours. What would you list as the top five (5) nursing considerations?
a. Assess LOC, provide BRAT diet, draw labs (CBC/BMP), assess I & Os, take the patient’s weight.
b. Note skin color, provide rehydration therapy with 5 mL of ginger ale every hour, weigh the child, diaper counts, and measure abdominal girth.
c. Assess vital signs, weigh the child, document the accurate I & O, observe for s/s of dehydration, and provide IV re-hydration therapy as ordered.
d. Check the capillary refill, check urine specific gravity, assess mucous membranes, provide IV hydration therapy of 1L bolus of NS, and note behavior changes.
ANS: C
You are caring for an infant who returned from the operating room for a cleft lip and cleft palate repair. Which of the following should you anticipate in the immediate post-operative period? SELECT ALL THE APPLY.
a. Apply elbow immobilizers.
b. Suction the mouth every 4 hours.
c. Resume feeding when tolerated.
d. Provide the infant a pacifier.
e. Lay the infant flat until the wound is fully healed.
ANS: A, C
The nurse provided education about surgical repair to the parents of a newborn male who was born with a mild hypospadias. Which statement by the parent indicates a need for further education?
a. “Surgery will help the child to void in the standing position later in life.”
b. “In most cases, the appearance after surgery will be a circumcised normal penis.”
c. “I will schedule a circumcision for the child as soon as possible.”
d. “The best time for surgical repair is usually at 6-12 months of age.”
ANS: B (& C)
The nurse knows that placement of a catheter into the esophagus of an infant born with esophageal atresia and tracheoesophageal fistula is often necessary in order to do which of the following?
a. Irrigate the esophagus.
b. Keep the esophagus patent.
c. Suction secretions from the esophageal pouch.
d. Administer broad-spectrum antibiotics.
ANS: C
The nurse is assigned to care for a premature infant. Which assessment finding would be most concerning for necrotizing enterocolitis?
a. Increasing abdominal girth.
b. Cyanosis.
c. Decreased gastric residuals.
d. Diarrhea.
ANS: A
A common postoperative complication after repair of a tracheoesophageal fistula and esophageal atresia is ____________.
ANS: tracheomalacia
The parents of a 10-month-old infant in your clinic states that the infant has been having paroxysms of inconsiderable fussiness, bilious vomiting, and you notice a palpable abdominal mass and blood stools in the diaper. Which of the following should you suspect?
a. Hirschsprung disease.
b. Esophageal atresia.
c. Pyloric stenosis.
d. Intussusception.
ANS: D
When assessing the penis of an uncircumcised neonate, the nurse notices that the foreskin does not easily retract. Which is most appropriate nursing action?
a. Alert the provider.
b. Apply increasing force until the foreskin can be pulled back completely.
c. Recommend circumcision to the parents.
d. Document the finding.
ANS: D
- The nurse reviews the records of a newborn was born premature, and is believed to have experienced both asphyxias. Which of the following could the nurse anticipate as preventative measures against necrotizing enterocolitis? SELECT ALL THE APPLY.
a. Withhold oral feelings for 24 hours.
b. Strict hand washing.
c. Routine barium enemas.
d. Feed the infant only hypertonic formula.
e. Abdominal decompression.
ANS: A, B
- When educating the mother of an infant born with an isolated cleft lip about feeding, which of the following should the nurse include?
a. “A nasogastric tube will have to be placed before discharge.”
b. “It may be helpful to bottle-feed using a nipple with a narrow base.”
c. “It is important to pause during feedings to burp the infant.”
d. “Most infants with isolated cleft lip are unable to effectively breastfeed.”
ANS: C
- The nurse reviews the record of a newborn infant and notes that diagnosis of Hirschsprung disease is suspected. The nurse expects to note which most likely sign of this condition documented in the record?
a. Hematemesis.
b. Undernourished appearance.
c. Failed to pass meconium in first 24 hours after birth.
d. Voracious appetite.
ANS: C
- While assessing a toddler immediately after a motor vehicle collision, the nurse notices that the child only responses to painful stimulation, and only with extension posturing. Which of the following words should the nurse use to describe the child’s level of consciousness?
a. Coma.
b. Lethargy.
c. Confusion.
d. Disorientation.
ANS: A
